Bill Text: HI SB963 | 2012 | Regular Session | Introduced
Bill Title: Workers' Compensation; Motor Vehicle Insurance; Accident and Health or Sickness Insurance
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2011-12-01 - Carried over to 2012 Regular Session. [SB963 Detail]
Download: Hawaii-2012-SB963-Introduced.html
|
THE SENATE |
S.B. NO. |
963 |
|
TWENTY-SIXTH LEGISLATURE, 2011 |
|
|
|
STATE OF HAWAII |
|
|
|
|
|
|
|
|
||
|
|
||
A BILL FOR AN ACT
relating to insurance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A to be appropriately designated and to read as follows:
"§431:10A‑ Consolidating claims for work-related injuries and motor vehicle related injuries. (a) If an insured makes a claim under an accident and health or sickness insurance contract, pursuant to chapter 431, article 10A, the insured shall be eligible for coverage, regardless of whether the accident or injury occurred as a result of an automobile accident or while the insured was at work.
(b) If an insured makes a claim pursuant to an accident and health or sickness insurance contract or plan for an accident or injury that occurred at the insured's place of employment, that shall not prevent a health insurance provider from seeking reimbursement from an appropriate workers' compensation plan.
(c) If an insured makes a claim pursuant to an accident and health or sickness insurance contract or plan for an accident or injury that occurred as the result of an automobile accident, that shall not prevent a health insurance provider from seeking reimbursement from the insured's automobile insurance company."
SECTION 2. Section 386-26, Hawaii Revised Statutes, is amended to read as follows:
"§386-26 Guidelines on
frequency of treatment and reasonable utilization of health care and services.
The director shall issue guidelines for the frequency of treatment and for
reasonable utilization of medical care and services by health care providers
that are considered necessary and appropriate under this chapter[.]; provided
that the waiting period to utilize medical care or services for patients
subject to this section shall be no more than days.
The guidelines shall not be considered as an authoritative prescription for
health care, nor shall they preclude any health care provider from drawing upon
the health care provider's medical judgment and expertise in determining the
most appropriate care.
The guidelines shall be adopted pursuant to chapter 91 and shall not interfere with the injured employee's rights to exercise free choice of physicians under section 386-21.
In addition, the director shall adopt updated medical fee schedules referred to in section 386-21, and where deemed appropriate, shall establish separate fee schedules for services of health care providers as defined in section 386-1 to become effective no later than June 30, 1986, in accordance with chapter 91."
SECTION 3. Section 431:10A-101, Hawaii Revised Statutes, is amended to read as follows:
"§431:10A-101 Applications and exceptions. This part shall apply to all policies of accident and health or sickness insurance delivered or issued for delivery in this State, except that nothing in this part shall apply to or affect:
(1) Any policy of workers' compensation insurance or
any policy of vehicle or liability insurance with or without supplementary
coverage therein[;], except as provided in section 431:10A‑ ;
(2) Any policy or contract of reinsurance;
(3) Any blanket or group policy of insurance; or
(4) Life insurance, endowment, or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to accident and health or sickness insurance as:
(A) Provide additional benefits in case of death, dismemberment, or loss of sight by accident; or
(B) Operate to safeguard such contracts against lapse, or to give a special surrender value, special benefit, or an annuity in the event that the insured or annuitant shall become totally and permanently disabled, as defined by the contract or supplemental contract."
SECTION 4. Section 431:10C-308.5, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:
"(b) The charges and frequency of treatment for services specified in section 431:10C-103.5(a), except for emergency services provided within seventy-two hours following a motor vehicle accident resulting in injury, shall not exceed the charges and frequency of treatment permissible under the workers' compensation supplemental medical fee schedule. Notwithstanding any law to the contrary, the waiting period for treatment for patients subject to this section shall be no more than days. Charges for independent medical examinations, including record reviews, physical examinations, history taking, and reports, to be conducted by a licensed Hawaii provider unless the insured consents to an out-of-state provider, shall not exceed the charges permissible under the appropriate codes in the workers' compensation supplemental medical fee schedule. The workers' compensation supplemental medical fee schedule shall not apply to independent medical examinations conducted by out-of-state providers if the charges for the examination are reasonable. The independent medical examiner shall be selected by mutual agreement between the insurer and claimant; provided that if no agreement is reached, the selection may be submitted to the commissioner, arbitration or circuit court. The independent medical examiner shall be of the same specialty as the provider whose treatment is being reviewed, unless otherwise agreed by the insurer and claimant. All records and charges relating to an independent medical examination shall be made available to the claimant upon request. The commissioner may adopt administrative rules relating to fees or frequency of treatment for injuries covered by personal injury protection benefits. If adopted, these administrative rules shall prevail to the extent that they are inconsistent with the workers' compensation supplemental medical fee schedule."
SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 6. This Act shall take effect upon its approval.
|
INTRODUCED BY: |
_____________________________ |
|
|
|
Report Title:
Workers' Compensation; Motor Vehicle Insurance; Accident and Health or Sickness Insurance
Description:
Allows an injured person to submit a claim for injuries suffered at work or in a motor vehicle accident through the injured person's accident and health or sickness insurance contract. Limits the waiting period for the receipt of treatment or medical care or services under workers' compensation or for an insured under motor vehicle insurance.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
